Ahmed Saad1, Mohit Kumar Patralekh2, Vijay Kumar Jain3, Sagaurav Shrestha4, Rajesh Botchu5, Karthikeyan P Iyengar6. 1. Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2WB, UK. 2. Central Institute of Orthopaedics, Safdarjung Hospital and VMMC, New Delhi, 110029, India. 3. Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India. 4. Foundation Year 2 Doctor in Surgery, Northampton General Hospital, Northampton, NN1 5BD, UK. 5. Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK. 6. Department of Orthopaedics, Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK.
Abstract
Purpose: Femoral neck fractures (FNF) in adults are conventionally managed with surgical options. This paper is aimed to assess the safety, and functional outcomes of the novel Femoral neck system (FNS) for FNF treatment in adult population. Methods: An organized quest of four literature databases (PubMed, Scopus, Web of Science, and Cochrane Library) was performed on March 1, 2022 using the term "femoral neck system". Fixed or random-effect meta-analysis was used to analyse the outcome measures after selecting relevant studies and assessing their quality. Heterogeneity was considered when calculating pooled effect sizes and 95% confidence ranges. Results: On comparing FNS with cannulated cancellous screws (CCS) or other methods, in a total of 762 patients (351 FNS and 411 CCS) in the 11 comparative studies considered for meta-analysis, blood loss was pointedly higher overall in the FNS group, mean difference 115.77 ml; 95% CI 3.11 ml, 28.42 ml; test of overall effect: z = 1.68, p = 0.09); with considerable heterogeneity. However, in the FNS group the operative time was substantially lower (Mean difference -7.91 min; 95% CI -15.01, -0.80; test of overall effect: z = 2.18, p = 0.03, with marked heterogeneity). Moreover, complications such as infections, non-union, osteonecrosis, implant cut-out were significantly lower in the FNS group with a Mantel Haenszel Odds ratio of 0.20 (95% CI 0.12, 0.34: Z = 6.01, p < 0.0001). Conclusion: Keeping in mind the heterogenicity of the studies, -management of adult patients with FNF with FNS can provide results comparable to traditional fixation methods with significantly lower rate of complications.
Purpose: Femoral neck fractures (FNF) in adults are conventionally managed with surgical options. This paper is aimed to assess the safety, and functional outcomes of the novel Femoral neck system (FNS) for FNF treatment in adult population. Methods: An organized quest of four literature databases (PubMed, Scopus, Web of Science, and Cochrane Library) was performed on March 1, 2022 using the term "femoral neck system". Fixed or random-effect meta-analysis was used to analyse the outcome measures after selecting relevant studies and assessing their quality. Heterogeneity was considered when calculating pooled effect sizes and 95% confidence ranges. Results: On comparing FNS with cannulated cancellous screws (CCS) or other methods, in a total of 762 patients (351 FNS and 411 CCS) in the 11 comparative studies considered for meta-analysis, blood loss was pointedly higher overall in the FNS group, mean difference 115.77 ml; 95% CI 3.11 ml, 28.42 ml; test of overall effect: z = 1.68, p = 0.09); with considerable heterogeneity. However, in the FNS group the operative time was substantially lower (Mean difference -7.91 min; 95% CI -15.01, -0.80; test of overall effect: z = 2.18, p = 0.03, with marked heterogeneity). Moreover, complications such as infections, non-union, osteonecrosis, implant cut-out were significantly lower in the FNS group with a Mantel Haenszel Odds ratio of 0.20 (95% CI 0.12, 0.34: Z = 6.01, p < 0.0001). Conclusion: Keeping in mind the heterogenicity of the studies, -management of adult patients with FNF with FNS can provide results comparable to traditional fixation methods with significantly lower rate of complications.
Authors: Hang Cheng; Jeffrey W Clymer; Brian Po-Han Chen; Behnam Sadeghirad; Nicole C Ferko; Chris G Cameron; Piet Hinoul Journal: J Surg Res Date: 2018-04-24 Impact factor: 2.192
Authors: J-E Gjertsen; T Vinje; L B Engesaeter; S A Lie; L I Havelin; O Furnes; J M Fevang Journal: J Bone Joint Surg Am Date: 2010-03 Impact factor: 5.284